,i  #aag? ,,congress  #a/ ,session  ,h4 
,r4 #ehhc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #d1 #bjba,ms4
 ,sewell 7= h]self & ,mr4 ,smi? (       
,nebraska7 introduc$ ! foll[+ bill2 :i* 
0 ref]r$ to ! ,committee on ,en]gy &    
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to e/abli% a       
value-bas$ c>e program to exempt        
eligible rural heal? cl9ics f c]ta9     
paym5t limitations1 & = o!r purposes4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,rural ,heal? ,fairness 9 ,competition
 ,act4  #b4 ,m$ic>e rural heal? cl9ic   
value-bas$ c>e program  7a7 ,m$ic>e     
rural heal? cl9ic value-,bas$ program ,n
 lat] ?an #ij days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices 7h]e9aft]      
ref]r$ to z ! ,secret>y7 %all e/abli% a 
,m$ic>e ,rural ,heal? ,cl9ic            

,value-,bas$ ,c>e ,program "u :i* an    
eligible cl9ic 7z def9$ 9 subsection    
7b77#a77;,b77 %all be exempt f any      
limitation on paym5t e/abli%$ "u section
 #ahcc7;a7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #aciel7a77 if su* cl9ic  
submits reports requir$ "u subsection   
7b77#b74  7b7 ,program requirem5ts  7#a7
 ,application  7,a7 ,9 g5]al ,!         
,secret>y %all e/abli% a process by :i* 
an eligible cl9ic may apply =           
p>ticipation 9 ! program describ$ 9     
subsection 7a74  7,b7 ,eligible cl9ic ,=
 purposes ( ?is section1 an eligible    
cl9ic is a rural heal? cl9ic 7z def9$ 9 
section #ahfa7;aa77#b7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciex7aa77#b777 t-- 7i7 is own$ or     
op]at$ by a hospital1 includ+ a critical
 access hospital1 ) less ?an #ej b$s2   
7ii7 is enroll$ "u section #ahff7;j7 (  
su* ,act 7includ+ tempor>y enrollm5t    
dur+ ! em]g5cy p]iod describ$ 9 section 
#aace7;g77#a77;,b7 ( su* ,act72 &  7iii7
 meets ! report+ requirem5ts e/abli%$ "u

 p>agraph 7#b72 or  7iv7 is p>ticipat+ 9
 a ,m$ic>e quality program1 includ+ !   
,national ,committee = ,quality         
,assurance ,pati5t-,c5t]$ ,m$ical ,home 
,recognition ,program1 or ano!r         
value-bas$ c>e program z det]m9$ by !   
,secret>y4  7#b7 ,reports  7,a7 ,9 g5]al
 ,n lat] ?an ! end ( ! fir/ cal5d> ye> 9
 :i* an eligible cl9ic p>ticipates 9 !  
program describ$ "u subsection 7a71 &   
annually !reaft]1 ea* eligible cl9ic    
%all submit to ! ,adm9i/rator ( ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices a report  
on ! quality measures describ$ 9        
subsection 7c77#a74  7,b7 ,subsequ5t    
ye>s ,n lat] ?an ! end ( ! ?ird cal5d>  
ye> 9 :i* an eligible cl9ic has         
p>ticipat$ 9 ! program describ$ "u      
subsection 7a71 & annually !reaft]1 su* 
eligible cl9ic %all submit to !         
,adm9i/rator a report conta9+ !         
in=mation requir$ "u subp>agraph 7,a71 &
 may submit additional in=mation )      
respect to p]=mance measures 7describ$ 9
 subsection 7c77#b77 z ! ,adm9i/rator   

may require4  7,c7 ,publication (       
reports ,n lat] ?an #ij days aft] ! la/ 
day ( ea* cal5d> ye> = :i* an eligible  
cl9ic has submitt$ a report pursuant to 
?is p>agraph1 ! ,adm9i/rator %all make  
su* report publicly available on !      
website ( ! ,c5t]s = ,m$ic>e  ,m$icaid  
,s]vices4  7#c7 ,duration ,! exemption f
 paym5t limitations "u section #ahcc7;a7
 %all apply = z long z an eligible cl9ic
 meets ! requirem5ts set =? 9 ?is       
subsection4  7c7 ,selection ( quality   
measures2 p]=mance /&>ds  7#a7          
,selection ( quality measures ,n lat]   
?an #ij days aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,secret>y %all select       
quality measures = purposes ( ! report+ 
requirem5ts "u subsection 7b77#b74 ,9   
select+ quality measures1 ! ,secret>y   
%all select su* measure t are-- 7,a7 us$
 9 exi/+ programs2  7,b7 focus$ on      
prim>y c>e2 or  7,c7 bas$ on input f    
/akehold]s4  7#b7 ,p]=mance /&>ds ,n    
lat] ?an #b ye>s aft] ! date ( !        
enactm5t ( ?is ,act1 ! ,secret>y may    

e/abli% p]=mance measurem5ts /&>ds =    
purposes ( ! report+ requirem5ts "u     
subsection 7b77#b74